阿替普酶与尿激酶溶栓治疗急性心肌梗死疗效探析

Analysis of Curative Effect of Alteplase Combined with Urokinase Thrombolytic Therapy of Acute Myocardial Infarction

目的分析和研究阿替普酶与尿激酶溶栓治疗急性心肌梗死临床治疗效果。方法选取该院2016年6月—2017年5月期间救治的AMI患者170例确定为分析对象,按随机原则分成两组各85例,观察组选择了阿替普酶溶栓法,对照组则选择了尿激酶溶栓法,然后将患者溶栓再通时间、死亡率和不良反应发生率进行对比。结果观察组起病6 h以内及超过6 h实施溶栓的血管再通率分别是70.97%、90.74%,均明显高于对照组,差异有统计学意义(χ~2=11.472、12.031,P<0.05);经过采取溶栓措施之后,观察组死亡、脑出血、以及牙龈出血、心源性休克和消化道出血、心力衰竭的发生率分别是1.18%、3.53%、2.35%、1.18%、2.35%、1.18%,均明显低于对照组,差异有统计学意义(χ~2=5.226、6.137、5.065、5.226、5.065、5.225,P<0.05)。结论阿替普酶的优势在于给药便利、以及血管开通率较高、使用安全等,对于出血风险不高、且起病时间短的患者来讲,尿激酶仍属于适合的选择。

Objective To analyze and study the clinical effect of alteplase combined with urokinase thrombolytic therapy of acute myocardial infarction. Methods 170 cases of AMI patients treated in our hospital from June 2016 to May2017 were selected and randomly divided into two groups with 85 cases in each, the observation group and the control group were respectively treated with alteplase combined with urokinase thrombolytic therapy, and the thromblytic recanalization time, morbidity and incidence rate of adverse reactions were compared between the two groups then. Results The thromblytic recanalization rates in 6 h and more than 6 h in the observation group were respectively 70.97%,90.74%, which were obviously higher than those in the control group, and the differences were statistically significant（χ2=11.472,12.031,P〈0.05）, after the thrombolytic treatment measures, the incidence rates of intracerebral hemorrhage,gingival bleeding, cardiogenic shock and gastrointestinal bleeding and heart failure in the observation group were respectively 1.18%,3.53%,2.35%,1.18%,2.35%,1.18%, which were obviously lower than those in the control group, and the differences were statistically significant（χ2=5.226,6.137,5.065,5.226,5.065,5.225,P〈0.05）. Conclusion The alteplase has the advantages of convenient administration, higher blood vessel recanalization rate, and safety usage, and the urokinase is still the suitable selection for patients with low bleeding risks and short onset time.